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The goal of integrated, multidisciplinary and person-centered care is on the welfare policy agenda in many countries, but how about integrated service delivery in action? This paper describes a three-year service journey of an elderly person from home to a nursing home through home care, specialized hospital and inpatient care. The aim of this viewpoint paper is to consider how customer orientation and integration are realized when an older lady living an active life becomes seriously ill and loses the ability to conduct daily functions.

The service path will be described from the perspective of a relative.

The paper raises questions related to governance as well as multidisciplinary and customer orientation in integrated care.

The paper discusses a real-life experience of an elderly care journey from active senior life to a nursing home in Finland. When making visible an elderly care journey, this gives real-life information about the challenges and the needs for development. Better practical understanding helps to remove inter-organizational barriers toward more integrated and patient safe care.

This paper investigates the relationship between health and labour market participation considering the potential role played by the presence of children and elderly persons (with/without disabilities) in Italian households.

The authors use longitudinal data from the European Union Statistics on Income and Living Conditions and full-information maximum likelihood to estimate a two-equation model (one equation for labour force participation and one for health status) with instruments to address the endogeneity of the labour force participation choice. The model is estimated separately by gender.

The authors find that while the presence of children, elderly persons or both is positively associated with the health status of both genders, the presence of disabled elderly persons exerts a negative role. As for participation, interesting differences emerge. The presence of children discourages women's participation but is positively associated with men's labour force participation. Interestingly, a caring role for elderly persons without disability emerges for both genders when the presence of children is combined with that of elderly people. Gender differences are also at work for the role of childcare services and elderly and/or disabled home care/assistance.

The findings indicate a possible caring role for elderly persons without disabilities, neutralizing the effect of the presence of children on the labour force participation of both genders. The results also suggest that greater coverage of care services should increase the active participation of women in the labour market.

The increasing size of the elderly population is emerging as a primary catalyst for the escalation of healthcare expenditure, and a sense of urgency is manifest. However, the complexity of the health- and elderly care systems provides challenges in improving system efficiency. Hence, the system-level understanding of the main obstacles to integration care needs further exploration. In order to better integrate health- and elderly care, the study needs to identify the actual misalignments underpinning the issue. This study provides the theoretical foundations for resource misalignments and provides empirical examples of these.

Semi-structured interviews with multiple stakeholders on various hierarchical levels were carried out to create a more complete view of the system and resources deployed in health- and elderly care. The application of user-centered design methods and co-creation with employees have also been crucial to the outcomes of the study.

Results show that health- and elderly care is a large-scale complex system. The overlapping and mutually reinforcing misalignments are: (1) regulation and policy differences, (2) stakeholder quantity and variation, (3) external control of health- and elderly care, (3) decreasing collaboration and (4) communication channels and IT development.

This qualitative study builds on institutional theory and resource integration theory and contributes with empirical descriptions of misalignments in the health- and elderly care system. These descriptions will serve as points of departure for systems design to improve the efficiency and effectiveness of health- and elderly care.

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.

Studies on the work integration of persons with disabilities (PwD) and the role of social dialogue therein are scarce. The study examines how the different systems of workers’ representation and industrial relations in Slovakia and Norway facilitate PwD work integration. Taking a social ecosystem perspective, we acknowledge the role of various stakeholders and their interactions in supporting PwD work integration. The paper’s conceptual contribution lies in including social dialogue actors in this ecosystem.

Evidence was collected via desk research, 35 semi-structured in-depth interviews with 51 respondents and stakeholder workshops in 2019–2020.

The findings from Norway confirm the expected coordination of unions and employers in PwD work integration. Evidence from Slovakia shows that in decentralised industrial relations systems, institutional constraints beyond the workplace determine employers’ and worker representatives’ approaches in PwD integration. Most policy-level outcomes are contested, as integration occurs predominantly via sheltered workplaces without interest representation.

This paper identifies the primary sources of variation in the work integration of PwD. It also highlights opportunities for social partners across both situations to exercise agency and engagement to improve PwD work integration.

By integrating two streams of literature – social policy and welfare state and industrial relations – this paper examines PwD work integration from a social ecosystem perspective. Empirically, it offers novel qualitative comparative evidence on trade unions’ and employers’ roles in Slovakia and Norway.

This systematic review paper aims to investigate seasonal ambient change’s impact on the incidence of falls among older adults.

The population, exposure, outcome (PEO) structured framework was used to frame the research question prior to using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. Three databases were searched, and a total of 12 studies were found for inclusion, and quality appraisal was carried out. Data extraction was performed, and narrative analysis was carried out.

Of the 12 studies, 2 found no link between seasonality and fall incidence. One study found fall rates increased during warmer months, and 9 of the 12 studies found that winter months and their associated seasonal changes led to an increase in the incidence in falls. The overall result was that cooler temperatures typically seen during winter months carried an increased risk of falling for older adults.

Additional research is needed, most likely examining the climate one lives in. However, the findings are relevant and can be used to inform health-care providers and older adults of the increased risk of falling during the winter.

Hazard risk communication has arguably been a challenge, especially in communities which are susceptible to multiple hazards. Orewa was specially chosen for this research in order to provide a complete assessment of the effectiveness of communicating New Zealand's early warning strategy in a multi-hazard area. Two categories of surveys were undertaken; experts and academics in emergency management and disaster risk resilience and the Orewa community. A semi-qualitative indicator-based analysis was conducted with the normalization of index values which resulted in four (4) categories; risk perception, risk awareness, risk governance and uncertainty, trust and credibility. The resulting vulnerability index indicated that risk perception and uncertainty, trust and credibility ranked the highest, followed by risk awareness and risk governance. Risk perception had stark differences between what the community perceives as being most at risk from to what the experts deem to be the highest risk for Orewa. This has implications for policy directives as well as funding for risk reduction. Uncertainty, trust and credibility was another area which indicated conflicting sentiments between the community and experts. The community generally trusts decision-makers but the experts think they don't. This shows that the community is aware of their risks, but may not necessarily believe that the experts are providing enough efforts in what is of importance to them. Risk governance is not a vulnerable area to the experts as they have been actively engaging in hazards that they deem Orewa was most at risk from. Any breakdown in communication can have detrimental effects if multiple hazards were to occur at once in the case of Orewa.

The purpose of this study is to explore how the personal traits of the informal entrepreneurs influence their formalization decisions.

This study adopted a qualitative approach using a multicase design in which 28 informal entrepreneurs situated in Kampala district, Uganda, were engaged. An interview guide, recorders and note books were used in data collection.

The results indicate that the traits of informal and semiformal entrepreneurs are distinct. Informal entrepreneurs have been noted to be more courageous and resilient, while their semiformal counterparts have greater passion for their businesses. It is thus observed that the formalization prospects are higher for the semiformal entrepreneurs than for their informal counterparts. Entrepreneurs that would be willing to formalize their businesses are discouraged by distance, technology and the cost of involving middlemen. Whereas the resilient entrepreneurs are noted to work through these challenges, the passive ones in both the informal and semiformal categories will not formalize their businesses by giving such excuses.

This study contributes to the extant literature on informal entrepreneurship by providing initial empirical evidence on how the personal traits of the entrepreneurs influence their formalization decisions specifically.

Given the importance of senior volunteers in an ageing society, this study aims to deepen the understanding of how seniors create well-being by volunteering as service providers in terms of motivations for volunteer participation and value co-creation/co-destruction in service provision.

Focussing on senior volunteers acting as service providers in the tourism sector, this study conducted a programme of qualitative research with 15 senior volunteer tour guides in Japan and the UK through the purposive sampling method. The data were analysed by the Gioia method to identify data structure and create a conceptual model.

Seniors start with a mixture of different motivations, not only symbolic and health ones. However, after a certain period of training, they become more aware of their volunteer role as service providers and may strive to maximise the benefits to their clients. The overall performance of such a role supports their well-being. They may also experience episodes of value co-destruction; such negative experiences may be overcome by building good relationships with their colleagues in the organisation.

The paper identifies organisational support ideas for senior service provider volunteers aimed at overcoming negative experiences and achieving well-being, in terms of training and improved communication between organisation members.

This study contributes to the transformative service research literature by constructing a model to showcase the relationship amongst expectations of volunteering as a service provider, service delivery and well-being creation. This paper also discusses the positive and negative effects of volunteer service delivery on senior volunteers' well-being.

Ireland’s ageing population has resulted in an increasing number of older adults living with frailty. Despite growing attention towards older adults’ and health professionals’ perspectives of frailty, occupational therapy research is limited. This study aims to explore occupational therapists’ perceptions of frailty and how their perceptions impact their approach to the assessment and management of frailty.

Using qualitative descriptive design, 19 occupational therapists working with older adults participated in online focus groups. Data were analysed using thematic analysis.

Perceptions of occupational therapists were constructed into three main themes: conceptualising frailty; management of frailty; and advancing frailty practice. Findings indicate that occupational therapists perceived frailty as a multidimensional concept but highlight a reluctance to use frailty terminology with patients. Findings also suggest that although occupational therapists are involved in provision of care for older adults living with frailty, the profession’s scope is not optimised in the assessment and management of frailty.

Findings provide insight into occupational therapists’ perceptions of frailty. Development of a shared understanding of frailty between clinicians and patients and enhancement of undergraduate frailty education are recommended to progress occupational therapy’s role in frailty management.